Strepsils Intensive spray oromucosal solution 8.75 mg/dose 15 ml bottle (5052197053241) Reckitt Benckiser (UK) - instructions, buy at a low price in Ukraine

Pharmacological properties

Pharmacodynamics.
Flurbiprofen is a propionic acid derivative NSAID that acts by inhibiting prostaglandin synthesis. flurbiprofen has a powerful analgesic, antipyretic and anti-inflammatory effect; Using cultured human cells as an example, it was shown that a single dose dissolved in artificial saliva reduces swelling of the mucous membrane of the respiratory tract. Based on studies using whole blood, flurbiprofen is a mixed cox-1/cog-2 inhibitor with some selectivity for cox-1. Preclinical studies indicate that the R(−) enantiomer of flurbiprofen and related NSAIDs may have CNS effects; the likely mechanism is the suppression of induced COX-2 at the level of the spinal cord.

A single dose of flurbiprofen 8.75 mg (three sprays) applied directly to the throat mucosa has been shown to reduce the severity of sore throat. In particular, swollen and inflamed irritated throat areas showed significant changes (AUC) compared to the baseline curve (mean difference (standard deviation)) of active treatment versus placebo 0–2 hours (−1.82 (1.35) versus − 1.13 (1.14)), 0–3 h (−2.01 (1.405) vs. −1.31 (1.233)), and 0–6 h (−2.14 (1.551) vs. − 1.50 (1.385)). Significant differences in AUC from baseline 0–6 hours compared to placebo were also seen for other pharyngitis symptoms, including pain intensity (−22.50 (17.894) vs. −15.64 (16.413)), difficulty swallowing ( −22.50 (18.260) vs. −16.01 (15.451)), swelling of the throat (−20.97 (18.897) vs. −13.80 (15.565)) and reduction in sore throat (3.24 (1.456) vs. 2 .47 (1.248)). Changes from baseline at individual time points for various pharyngitis characteristics were significant from 5 min to 6 h.

In patients taking antibiotics for streptococcal infection, the reduction in the severity of pharyngitis symptoms was statistically more significant after taking flurbiprofen 8.75 mg lozenges 7 hours and further after taking antibiotics. The analgesic effect of flurbiprofen 8.75 mg lozenges is not reduced by the use of antibiotics to treat patients infected with streptococcal throat infections.

Efficacy has also been demonstrated after multiple doses over 3 days. Strepsils Intensive, oromucosal spray, solution - simple and easy to use, which, when applied to the inflamed area of the throat, restores the voice, while at the same time soothing and softening the throat.

Pharmacokinetics

Suction. A single dose of flurbiprofen 8.75 mg (3 sprays) goes directly into the throat; flurbiprofen is easily absorbed, and is detected in the blood after 2–5 minutes, Cmax in blood plasma is reached 30 minutes after administration, but the concentration value remains at an average low level of 1.6 mcg/ml, approximately 4 times lower than per tablet 50 mg. Strepsils Intensive is bioequivalent to flurbiprofen lozenges 8.75 mg. Absorption of flurbiprofen occurs from the oral cavity by passive diffusion. The rate of absorption depends on the dosage form. The same value of peak concentrations after the use of oromucosal spray is achieved faster than after the use of an equivalent dose taken orally.

Distribution. Flurbiprofen is rapidly distributed in the body and binds to blood plasma proteins.

Metabolism/excretion. Flurbiprofen is metabolized by hydroxylation and excreted by the kidneys. T½ is 3–6 hours. Flurbiprofen passes into breast milk only in minimal quantities (0.05 mcg/ml). Approximately 20–25% of flurbiprofen when administered orally is excreted from the body unchanged.

Special groups. There were no differences in pharmacokinetic parameters between elderly and young adult volunteers following oral administration of flurbiprofen tablets.

Strepsils® Intensive

The simultaneous use of the drug with the following drugs should be avoided:

- Acetylsalicylic acid: with the exception of low doses of acetylsalicylic acid (no more than 75 mg per day) prescribed by a doctor, since combined use may increase the risk of side effects.

- Other NSAIDs, including ibuprofen and selective cyclooxygenase-2 inhibitors: The simultaneous use of two or more NSAIDs should be avoided due to a possible increased risk of side effects.

Use with caution simultaneously with the following medications:

- Anticoagulants: NSAIDs may enhance the effects of anticoagulants, including warfarin.

- Antiplatelet agents and selective serotonin reuptake inhibitors: increased risk of gastrointestinal bleeding.

- Antihypertensives (ACE inhibitors and angiotensin II antagonists) and diuretics: NSAIDs may reduce the effectiveness of these drugs and may increase nephrotoxicity due to inhibition of cyclooxygenase, especially in patients with impaired renal function (it is necessary to ensure adequate fluid replacement in such patients).

— Ethanol: may increase the risk of adverse reactions, especially gastrointestinal bleeding.

- Cardiac glycosides: simultaneous use of NSAIDs and cardiac glycosides can lead to worsening heart failure, a decrease in glomerular filtration rate and an increase in the concentration of cardiac glycosides in the blood plasma.

— Cyclosporine: increased risk of nephrotoxicity.

- Glucocorticosteroids: increased risk of gastrointestinal ulcers and gastrointestinal bleeding.

— Lithium preparations: there is evidence of the likelihood of an increase in the concentration of lithium in the blood plasma during the use of NSAIDs.

- Methotrexate: there is evidence of the likelihood of an increase in the concentration of methotrexate in the blood plasma during the use of NSAIDs. It is necessary to take NSAIDs 24 hours before or after taking methotrexate.

- Mifepristone: NSAIDs should be started no earlier than 8-12 days after stopping mifepristone, since NSAIDs may reduce the effectiveness of mifepristone.

- Quinolone antibiotics: in patients receiving concomitant treatment with NSAIDs and quinolone antibiotics, the risk of seizures may increase.

- Tacrolimus: when used together with NSAIDs, there may be an increased risk of nephrotoxicity.

- Zidovudine: when used together with NSAIDs, there may be an increased risk of hematotoxicity.

- Oral hypoglycemic drugs: changes in blood glucose concentrations are possible (it is recommended to increase the frequency of monitoring blood glucose concentrations).

- Phenytoin: an increase in the concentration of phenytoin in the blood serum is possible (monitoring the concentration of phenytoin in the blood serum and, if necessary, dose adjustment is recommended).

- Potassium-sparing diuretics: Concomitant use of potassium-sparing diuretics and flurbiprofen may lead to hyperkalemia.

- Probenecid and sulfinpyrazone: Medicines containing probenecid or sulfinpyrazone may delay the elimination of flurbiprofen.

- Tolbutamide and antacids: To date, studies have not identified interactions between flurbiprofen and tolbutamide or antacids.

Application

For oromucosal use. for short-term use only. in adults, use 1 dose (3 sprays) on the back wall of the mouth every 3–6 hours if necessary, but not more than 5 doses per day.

Do not inhale while spraying.

It is not recommended to use the drug for more than 3 days.

Before first use, you must activate the sprayer. To do this, turn the nozzle away from you and press the cap at least 4 times until the spray begins to spray in the form of a transparent, uniform cloud. This way the medicine will fall into the nebulizer and the spray will be ready for use.

Before using each subsequent dose, you must turn the nozzle away from you, press the cap at least 1 time and make sure that the spray is sprayed in the form of a transparent, uniform cloud. Each time before use, it is necessary to check the presence of spray in the form of a homogeneous cloud.

Elderly patients should use the lowest possible effective dose for the shortest period of time.

Use the lowest effective dose needed to control symptoms for the shortest period of time (see PRECAUTIONS).

Contraindications

Hypersensitivity to flurbiprofen or any component of the drug.

Hypersensitivity reactions (eg asthma, bronchospasm, rhinitis, angioedema or urticaria) after the use of acetylsalicylic acid or other NSAIDs.
Recurrent gastric ulcer/bleeding in history or in the acute phase (two or more episodes confirmed by characteristic clinical manifestations) and intestinal ulcer.
History of gastrointestinal bleeding or perforation, severe colitis, hemorrhagic or hematopoietic disorders associated with previous NSAID therapy.
Last trimester of pregnancy.
Severe heart failure, severe renal failure, or severe liver failure.
Children's age (up to 18 years).

Strepsils Intensive spray dosage for places approx 8.75 mg/dose 15 ml (fl)

Use with caution simultaneously with the following drugs: • Anticoagulants: NSAIDs may enhance the effects of anticoagulants, including warfarin.

• Antiplatelet agents and selective serotonin reuptake inhibitors: increased risk of gastrointestinal bleeding.

• Antihypertensives (ACE inhibitors and angiotensin II antagonists) and diuretics: NSAIDs may reduce the effectiveness of these drugs and may increase nephrotoxicity due to cyclooxygenase inhibition, especially in patients with impaired renal function (it is necessary to ensure adequate fluid replacement in such patients).

• Ethanol: may increase the risk of adverse reactions, especially gastrointestinal bleeding.

• Cardiac glycosides: simultaneous use of NSAIDs and cardiac glycosides can lead to worsening heart failure, a decrease in glomerular filtration rate and an increase in the concentration of cardiac glycosides in the blood plasma.

• Cyclosporine: increased risk of nephrotoxicity.

• Glucocorticosteroids: increased risk of gastrointestinal ulceration and gastrointestinal bleeding.

• Lithium preparations: there is evidence of the likelihood of an increase in the concentration of lithium in the blood plasma during the use of NSAIDs.

• Methotrexate: there is evidence of the likelihood of an increase in the concentration of methotrexate in the blood plasma during the use of NSAIDs. It is necessary to take NSAIDs 24 hours before or after taking methotrexate.

• Mifepristone: NSAIDs should be started no earlier than 8-12 days after stopping mifepristone, as NSAIDs may reduce the effectiveness of mifepristone.

• Quinolone antibiotics: Patients receiving concomitant treatment with NSAIDs and quinolone antibiotics may have an increased risk of seizures.

• Tacrolimus: when used together with NSAIDs, there may be an increased risk of nephrotoxicity.

• Zidovudine: when used in combination with NSAIDs, there may be an increased risk of hematotoxicity.

• Oral hypoglycemic drugs: changes in blood glucose concentrations are possible (it is recommended to increase the frequency of monitoring blood glucose concentrations).

• Phenytoin: an increase in the concentration of phenytoin in the blood serum is possible (monitoring the concentration of phenytoin in the blood serum and, if necessary, dose adjustment is recommended).

• Potassium-sparing diuretics: Concomitant use of potassium-sparing diuretics and flurbiprofen may lead to hyperkalemia.

• Probenecid and sulfinpyrazone: Medicines containing probenecid or sulfinpyrazone may delay the elimination of flurbiprofen.

• Tolbutamide and antacids: To date, studies have shown no interactions between flurbiprofen and tolbutamide or antacids.

Side effects

Cases of hypersensitivity reactions to NSAIDs have been reported, namely:

nonspecific allergic reactions and anaphylaxis;
airway reactivity, eg asthma, exacerbation of asthma, bronchospasm, shortness of breath;
various skin reactions, such as itching, urticaria, angioedema and, less commonly, exfoliative and bullous dermatitis (including epidermal necrolysis and erythema multiforme).

Edema, hypertension and heart failure have been reported in association with NSAID treatment. There is insufficient data to exclude such a risk when using the oral spray flurbiprofen solution.

The following adverse reactions have been observed during short-term use of flurbiprofen. The frequency of adverse reactions is determined as follows: very often (1/10), often (1/100–1/10), infrequently (1/1000–1/100), rarely (1/10,000–1/1000), very rare (1/10,000), unknown (cannot be estimated from available data).

From the blood and lymphatic system: unknown - anemia, thrombocytopenia.

From the cardiovascular and cerebrovascular system: unknown - edema, arterial hypertension and heart failure.

From the nervous system: often - dizziness, headache, paresthesia (tingling sensation, numbness, itching); infrequently - drowsiness.

From the respiratory system, chest and mediastinal organs: often - irritation in the throat; uncommon - exacerbation of asthma and bronchospasm, shortness of breath, wheezing, blisters in the oropharynx, pharyngeal hypoesthesia.

From the gastrointestinal tract: often - diarrhea, throat ulcers, nausea, pain in the mouth, paresthesia in the mouth, pain in the oropharynx, oral discomfort (feeling of warmth, burning or tingling in the mouth); uncommon - bloating, abdominal pain, constipation, dry mouth, dyspepsia, flatulence, burning mouth syndrome, dysgeusia, oral dysesthesia, vomiting.

From the skin and subcutaneous tissue: infrequently - various skin rashes, itching; unknown - severe forms of skin reactions, such as bullous reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis.

General conditions and local reactions: infrequently - fever, pain.

From the immune system: rarely - anaphylactic reactions.

Mental disorders: infrequently - insomnia.

From the liver and biliary tract: unknown - hepatitis.

If undesirable reactions occur, you should stop treatment and consult a doctor.

Strepsils intensive

Strepsils Intensive (flurbiprofen) is an NSAID in the form of lozenges for use in otorhinolaryngological and dental practice. Shows a pronounced analgesic, anti-inflammatory and antipyretic effect. Inhibits the enzyme COX types 1 and 2 (mostly COX-1), which leads to a decrease in the formation of nociceptive, hyperthermic and pro-inflammatory mediators of prostaglandins. Anesthetizes and relieves inflammation of the mucous membrane of the oral cavity and oropharynx, prevents excess accumulation of fluid in the mucous membrane, facilitates swallowing, and eliminates pain and discomfort in the throat. The drug begins to act within two minutes after administration. In terms of pain intensity, the effect becomes more pronounced after the 20th minute. The peak effect of the drug is observed after 1-1.5 hours. The duration of action of the drug is up to four hours. The time for complete dissolution of the tablet in the oral cavity takes from 5 to 12 minutes. The active substance has a high degree of absorption and enters the bloodstream after just five minutes. Peak concentration in the blood is reached after 40–45 minutes. In the liver it undergoes metabolic transformations by introducing a hydroxyl group into the molecule. Elimination from the body occurs mainly through urine and to a small extent through bile, with approximately a quarter of the administered dose being excreted unchanged. The half-life varies from 3 to 6 hours. Strepsils Intensive is indicated for the symptomatic treatment of ENT infections accompanied by pain in the mouth and pharynx. Single dose – 1 tablet. Frequency of use: every 3-6 hours, so that no more than 5 tablets are taken per day. Strepsils Intensive is indicated for short-term use only. The maximum duration of the medication course is 3 days. If after this time signs of the disease persist or become more severe, treatment should be interrupted and medical advice should be sought.

The likelihood of developing unwanted side effects can be minimized if you take the drug for a short time and do not exceed the recommended dosage. Typical side effects when taking Strepsils Intensive: headache, dizziness, spontaneously occurring sensations of burning, tingling, crawling, irritation in the throat, diarrhea, ulcerative lesions of the oral mucosa, discomfort in the oral cavity. Strepsils Intensive is not used for hypersensitization of the body and frequent development of local immune (allergic) reactions in response to aspirin or other NSAIDs, manifested by bronchospasm, nasal congestion and rhinorrhea, angioedema, urticaria, nasal polyposis or polyposis of the paranasal sinuses, ulcerative-erosive lesions of the gastrointestinal tract, acute ulcer bleeding, hemophilia, severe liver and kidney diseases, laboratory-diagnosed hypokalemia, as well as in the third trimester of pregnancy. In pediatric practice, the drug is used starting from the age of 12. The drug contains sugar as an auxiliary component, which must be taken into account by people suffering from diabetes. If symptoms of damage to the mucous membrane of the gastrointestinal tract occur, it is necessary to organize strict monitoring of the patient’s condition, including endoscopy, laboratory tests of blood and stool. Strepsils Intensive is not recommended to be combined with the consumption of ethanol-containing products. Due to the risk of deterioration in the functional characteristics of the kidneys, persons suffering from insufficiency of kidney and liver function, as well as those who are elderly, should consult a doctor before using the drug. The drug is not recommended to be combined with other NSAIDs to avoid increasing the risk of side effects. Caution is required when combining Strepsils Intensive with anticoagulants.

special instructions

Side effects can be reduced by short-term use of the minimum effective dose required to relieve symptoms.

Infections. Since in some cases, exacerbation of infectious inflammation (for example, the development of necrotizing fasciitis) has been described in temporary association with the use of systemic NSAIDs, the patient is advised to immediately consult a doctor if signs of a bacterial infection occur or the condition worsens during therapy with flurbiprofen in the form of a spray. The need for anti-infective antibiotic therapy should be considered.

In cases of purulent bacterial pharyngitis/tonsillitis, the patient is advised to consult a doctor, as the treatment should be reconsidered.

Treatment should be carried out for no more than 3 days.

If symptoms worsen or new symptoms appear, it is recommended to consult a doctor as treatment may need to be reconsidered.

If irritation occurs in the mouth, treatment with flurbiprofen should be discontinued.

In elderly patients, the incidence of adverse reactions caused by the use of NSAIDs is increased, especially gastrointestinal bleeding or perforation, which can be fatal.

Bronchospasm may occur in patients with asthma or allergic diseases, as well as a history of bronchospasm.

It is not recommended to use flurbiprofen in parallel with other NSAIDs, including selective COX-2 inhibitors.

Systemic lupus erythematosus and systemic connective tissue diseases cause an increased risk of aseptic meningitis, but the effect is usually not observed with short-term, limited use of drugs such as flurbiprofen spray.

Heart, kidney and liver failure. NSAIDs cause nephrotoxicity in various forms, including interstitial nephritis, nephrotic syndrome, and renal failure. The use of NSAIDs can lead to a dose-dependent decrease in prostaglandin production and provoke renal failure. Patients with renal failure, heart failure, impaired liver function, patients taking diuretics and the elderly are at greatest risk, but this effect is not usually seen with short-term, limited use of drugs such as flurbiprofen spray.

Liver dysfunction (see CONTRAINDICATIONS and SIDE EFFECTS).

Effect on the cardiovascular and cerebrovascular system: caution should be exercised (after consultation with a doctor) in starting the use of drugs with the active substance flurbiprofen in patients who have high blood pressure and/or heart failure, since fluid retention, increased blood pressure and swelling.

Clinical research and epidemiological data indicate that the use of certain NSAIDs (especially in high doses and for a long time) increases the risk of arterial thrombotic complications (for example, myocardial infarction or stroke). There is insufficient data to exclude such a risk when using 5 doses per day (1 dose - 3 sprays).

Symptoms from the nervous system. Long-term use of analgesics or off-label use may lead to headaches that cannot be treated with increased doses of the drug.

Effect on the gastrointestinal tract: NSAIDs should be used with caution in patients with a history of ulcerative colitis or Crohn's disease, as their condition may worsen.

Gastrointestinal bleeding, ulceration or perforation, which can be fatal, has been reported with all NSAIDs, with or without worsening symptoms or a history of serious adverse gastrointestinal symptoms.

The risk of gastrointestinal bleeding, ulceration and perforation increases with increasing dose of NSAIDs in patients with a history of gastric or duodenal ulcers, especially those complicated by bleeding or perforation (see CONTRAINDICATIONS) and in elderly patients, but this effect is not usually observed with short-term limited use of drugs such as flurbiprofen in spray form. Patients with a history of gastrointestinal toxicity, particularly the elderly, should report any unusual abdominal symptoms (especially gastrointestinal bleeding) to their physician.

Use with caution in patients receiving concomitant medications that increase the risk of ulceration or bleeding, particularly oral corticosteroids, anticoagulants such as warfarin, selective serotonin reuptake inhibitors, or antiplatelet agents such as acetylsalicylic acid (see INTERACTIONS).

If a patient receiving flurbiprofen develops bleeding or gastrointestinal ulcers, treatment should be discontinued.

Hematological phenomena. Flurbiprofen, like other NSAIDs, may inhibit platelet aggregation and prolong bleeding time. Flurbiprofen spray should be used with caution in patients with potential for abnormal bleeding.

Skin reactions such as exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis have occurred very rarely. Patients should discontinue treatment with flurbiprofen at the first appearance of rash, mucosal damage, or other manifestations of hypersensitivity (see ADVERSE EFFECTS).

The drug contains methyl parahydroxybenzoate and propyl parahydroxybenzoate, which may cause allergic reactions (possibly delayed).

Use during pregnancy and lactation. Pregnancy. Inhibition of prostaglandin synthesis may adversely affect pregnancy and/or embryonic/fetal development. Data from epidemiological studies indicate an increased risk of miscarriage and heart disease with gastroschisis after use of a prostaglandin synthesis inhibitor in early pregnancy. The absolute risk of developing heart disease increased from less than 1% to 1.5%. The risk is believed to increase with increasing dose and duration of therapy. In animals, administration of a prostaglandin synthesis inhibitor led to an increase in the number of pre- and post-implantation fetal deaths and embryo-lethality. In addition, an increase in the incidence of various malformations, including cardiovascular defects, has been reported in animals treated with a prostaglandin synthesis inhibitor during the period of organogenesis. Flurbiprofen should not be used in the first and second trimesters of pregnancy.

The drug is contraindicated in the third trimester of pregnancy, since all inhibitors of prostaglandin synthesis can provoke:

in the fetus: cardiopulmonary toxicity (with premature closure of the ductus arteriosus and the development of pulmonary hypertension), impaired renal function progressing to renal failure, low or polyhydramnios;
in mother and newborn: prolonged bleeding due to the antiaggregation effect, which can occur even at very low doses; inhibition of contractions of the uterine muscles, which leads to a delay or prolongation of labor.

Lactation. A small amount of flurbiprofen has been detected in human milk, but no negative effects of flurbiprofen on breastfed newborns have been noted. The use of the drug should be avoided during breastfeeding.

Reproductive function. There is some evidence that COX-inhibiting/prostaglandin-synthesizing drugs can negatively affect female reproductive function, namely ovulation. After cessation of treatment, reproductive function is restored.

Children. The safety and effectiveness of Strepsils Intensive in children (under 18 years of age) have not been established.

The ability to influence reaction speed when driving vehicles or working with other mechanisms. When using NSAIDs - dizziness, drowsiness, fatigue and visual disturbances. If this side effect occurs, then driving vehicles and other machinery is not recommended.

Strepsils Intensive Spray, 15 ml, 8.75 mg/dose, for topical use

Interaction with other drugs

The simultaneous use of the drug with the following drugs should be avoided: • Acetylsalicylic acid: with the exception of low doses of acetylsalicylic acid (no more than 75 mg per day) prescribed by a doctor, since combined use may increase the risk of side effects. • Other NSAIDs, including ibuprofen and selective cyclooxygenase-2 inhibitors: Concomitant use of two or more NSAIDs should be avoided due to a possible increased risk of side effects. Use with caution simultaneously with the following drugs: • Anticoagulants: NSAIDs may enhance the effects of anticoagulants, including warfarin. • Antiplatelet agents and selective serotonin reuptake inhibitors: increased risk of gastrointestinal bleeding. • Antihypertensives (ACE inhibitors and angiotensin II antagonists) and diuretics: NSAIDs may reduce the effectiveness of these drugs and may increase nephrotoxicity due to cyclooxygenase inhibition, especially in patients with impaired renal function (it is necessary to ensure adequate fluid replacement in such patients). • Ethanol: may increase the risk of adverse reactions, especially gastrointestinal bleeding. • Cardiac glycosides: simultaneous use of NSAIDs and cardiac glycosides can lead to worsening heart failure, a decrease in glomerular filtration rate and an increase in the concentration of cardiac glycosides in the blood plasma. • Cyclosporine: increased risk of nephrotoxicity. • Glucocorticosteroids: increased risk of gastrointestinal ulceration and gastrointestinal bleeding. • Lithium preparations: there is evidence of the likelihood of an increase in the concentration of lithium in the blood plasma during the use of NSAIDs. • Methotrexate: there is evidence of the likelihood of an increase in the concentration of methotrexate in the blood plasma during the use of NSAIDs. It is necessary to take NSAIDs 24 hours before or after taking methotrexate. • Mifepristone: NSAIDs should be started no earlier than 8-12 days after stopping mifepristone, as NSAIDs may reduce the effectiveness of mifepristone. • Quinolone antibiotics: Patients receiving concomitant treatment with NSAIDs and quinolone antibiotics may have an increased risk of seizures. • Tacrolimus: when used together with NSAIDs, there may be an increased risk of nephrotoxicity. • Zidovudine: when used together with NSAIDs, there may be an increased risk of hematotoxicity. m • Oral hypoglycemic drugs: possible changes in blood glucose concentrations (it is recommended to increase the frequency of monitoring blood glucose concentrations). • Phenytoin: an increase in the concentration of phenytoin in the blood serum is possible (monitoring the concentration of phenytoin in the blood serum and, if necessary, dose adjustment is recommended). • Potassium-sparing diuretics: Concomitant use of potassium-sparing diuretics and flurbiprofen may lead to hyperkalemia. • Probenecid and sulfinpyrazone: Medicines containing probenecid or sulfinpyrazone may delay the elimination of flurbiprofen. • Tolbutamide and antacids: To date, studies have shown no interactions between flurbiprofen and tolbutamide or antacids.

Interactions

Avoid simultaneous use of flurbiprofen with:

acetylsalicylic acid, unless it was prescribed by a doctor in low doses (not higher than 75 mg/day), as this can lead to adverse reactions;
other NSAIDs, including selective COX-2 inhibitors, as this increases the risk of side effects (especially gastrointestinal side effects such as ulcers and bleeding).

Flurbiprofen should be used with caution in combination with drugs such as:

Anticoagulants. NSAIDs may enhance the effect of anticoagulants such as warfarin.

Antihypertensive drugs and diuretics, ACE inhibitors, angiotensin II receptor antagonists. NSAIDs may reduce the therapeutic effect of these drugs. The risk of developing nephrotoxicity increases.

Corticosteroids increase the risk of gastrointestinal bleeding or ulcers.

Cardiac glycosides. They can exacerbate heart failure, reduce glomerular filtration rate and increase the level of glycosides in the blood plasma. It is recommended to monitor the patient's condition and, if necessary, dose adjustment.

Antiplatelet and selective serotonin inhibitors. The risk of gastrointestinal bleeding increases.

Lithium. Possible increase in serum lithium levels.

Methotrexate. The use of NSAIDs within 24 hours before or after the use of methotrexate may lead to increased concentrations of methotrexate and increased toxicity.

Cyclosporines. Increased risk of nephrotoxicity.

Mifepristone. NSAIDs should not be used for 8-12 days after using mifepristone - this may reduce the effect of mifepristone.

Tacrolimus. Increased risk of nephrotoxicity.

Zidovudine. There is an increased risk of hematological toxicity with concomitant use of NSAIDs.

Quinolone antibiotics. Increases the risk of seizures.

Oral antidiabetic agents. Blood glucose levels may change (increased blood glucose control is recommended).

Phenytoin. It is possible to increase the level of phenytoin in the blood plasma. Monitoring of the patient's condition and, if necessary, dose adjustment is required.

Potassium-sparing diuretics. Hyperkalemia may occur.

Probenecid, sulfinpyrazone. Flurbiprofen is released slowly.

Alcohol. The risk of adverse reactions, especially bleeding in the gastrointestinal tract, increases.

STREPSILS INTENSIVE spray external. 8.75 mg/dose vial. 15 ml

Interaction

The simultaneous use of the drug with the following drugs should be avoided:
- Acetylsalicylic acid: with the exception of low doses of acetylsalicylic acid (no more than 75 mg per day) prescribed by a doctor, since combined use may increase the risk of side effects.

- Other NSAIDs, including ibuprofen and selective cyclooxygenase-2 inhibitors: The simultaneous use of two or more NSAIDs should be avoided due to a possible increased risk of side effects.

Use with caution simultaneously with the following medications: